Help with questions....

[FF-EMT Diver]

I agree with your statement that the poster should know his stuff as well as study like crazy I spent mutiple hours studying myself, But the Op has already finished school so if he isnt prepared then shame on his Instruc, But I am saying that constructive encouragement goes a lot farther than destructive discouragement, Again I am not griping about the NREMT testing it is what it is, And I can see where maybe it may really be the best way to test one's ability to think under pressure for the best answer( Nervousness of testing, Time Limits, ETC...), Although I do not feel that the test really tested my field skills, It tested my ability to quess what they were asking for. Also I want to say I appreciate the posts from experienced people as yourself and ridryder I have been browsing over the whole site and can see that ya'll contribute a lot of information on a lot of different subjects it shows that ya'll are knowledgable on a lot of issues, BUT in my honest opinion some posters jumped on the OP to strongly without knowing a little background, (Just my.02)

 

[GonnaBeEMT]

.......as for moving the stretcher on uneven ground (such as grass, gravel, etc), I have always added a little 'lift' with my partner to it. Kinda like holding it up while keeping majority of the weight on the ground. basically like adding suspension. that and our stretcher has the nice rugged wheels (made for snow I believe)!

This may seem like common sense, but go up or down an incline with the patient's head facing forward. Don't push a stretcher up or down an incline sideways, because they tip over reeeeeally easy that way.

 

[Caligrown916]

Took my test ended at about 72 and im pretty sure that I got the last one wrong so now im pretty nervous. The last question was something like call to a drunk uncoopertive 15 yr old that fell and complains of neck pain. I was split on having law enforcement contact parents or contact parents to sign refusal form.

 

[T1medic]

As for the stretcher over rough terrain if I recall my text correctly, the best way to transport is in the lowest position possibly.

 

[daimere]

I am only half way through my training but can answer most those questions. It's in your book. Study a little more. Go back to your institution of learning and ask the instructors. I know mine would welcome someone asking something like that. Practice your test taking skills.

 

[lalaneedstopass]

Took my test ended at about 72 and im pretty sure that I got the last one wrong so now im pretty nervous. The last question was something like call to a drunk uncoopertive 15 yr old that fell and complains of neck pain. I was split on having law enforcement contact parents or contact parents to sign refusal form.

Well technically, the p/t is a child. Therefore, wouldn't this be implied consent and you have to treat the p/t? And if they are uncooperative you would attempt to restrain? I mean I'm still a student so I'm not really sure on it. But whether the p/t is 15 or 3 you still treat them because they are still considered a child and you contact the parents for a possible rendezvouz if they decide against treating the child. You don't just call and wait for them. But that is just my opinion, like I said I'm still learning so I have no idea. But I would love to know the answer of what to do in that case. Because anybody under the age of 18 is a child and unless parents are present it is implied consent. Unless they are 16 and pregnant or the parents are present then it would be based on expressed consent. Because what if the parents are present with this drunk 15 y/o and they are saying to treat the p/t. Their expressed consent over rules the childs. And if they deny and you believe the child needs to be transported then you express your feelings and try to persuade the parents the necessity of it, sign refusal, document, and have law enforcement take it up with them. :unsure:

 

[lalaneedstopass]

So I have my retest scheduled on thursday. I was hoping you guys could help me out. I know some are really basic but its more for me to clear stuff up.

-So if you have or come a across a patient that becomes or is pulseless and apneic you always apply an AED first thing right?

-Also if you are off duty and you find a person with no pulse should you phone for EMS and then do CPR or do you do perform CPR for a minute and then phone for EMS?

-What is the best way to move a stretcher over uneven ground?

-You got a pregnate patient saying that her water broken and that she feels like the baby is comin. Is this when you would look for crowning? And is crowning the sign that the baby needs to be delivered on the spot?

Please don't respond unless you got input on the questions.

I know it says don't respond unless you have input, but I have to agree with the majority of the responses. These are clear cut answers. I know after 2 times of failure the questions are tricky but those first 2 questions are definitely in my CPR book which is only about 30 pages. Not only that, they are in my textbook. And they aren't answers where you start and page 2 and have to flip to page 300 for more extent on one part and then page 150 for another part. They are all right there. The stretcher question should also be located within moving and lifting p/ts and basically common sense. Move it carefully!! and depending on the p/t condition and the environment is what type of stretcher and how to move it and such. Such as the pregnant p/t, like someone else had said you need to ask all those basic questions for any pregnant p/t, baby coming or not. And if the baby is crowning, that's basically embedded into my brain whether or not you deliver. Just because crowning is present doesn't mean deliver ASAP. You have to ask all the basic questions first to determine whether or not it's even SAFE to deliver on the spot. You have to make sure everything is stable, make sure this is a normal birth, make sure of no possible complications. Just because you see the head and the p/t is 35 weeks gestation are you going to want to deliver? What about cord around the neck you can't get off? Your pregnant question is very very broad.

 

[Caligrown916]

Got my results today and I PASSED!!!! I guess the last question doesn't really mean anything. Thanks to all who helped.

 

[CPG]

Got my results today and I PASSED!!!! I guess the last question doesn't really mean anything. Thanks to all who helped.

Congrats to you!! Now the real education begins.

I have had my eyes opened since I joined a service. It is not all fun and games, and all that basic assessment kinda goes out the window.

Just remember.....Get your people to the bus in 10 minutes or less, you can assess on the way to the hospital.

All Traumas (within reason) are PUHA (Pick Up Haul ***)

Good luck EMT!!

 

[JPINFV]

I have had my eyes opened since I joined a service. It is not all fun and games, and all that basic assessment kinda goes out the window.

Mind clarifying that statement for me? There's two ways I can see that being interpreted as, and one is spot on and the other is dreadful.

 

[CPG]

Mind clarifying that statement for me? There's two ways I can see that being interpreted as, and one is spot on and the other is dreadful.

Sure..

For example, Cardiac patient.

In school you learn all the basic assessment crud, SAMPLE, rapid pat-down to determine DCAPBTLS, OPQRST, load into bus, go to hospital.

In real life.....Get on scene, find patient, load into ambulance, start headed to hospital, then SAMPLE, monitor for SpO2, NIPB, IV start.

In other words, what you learn in school is not really what you do in the field. The class is meant to teach you to pass the exam and practicals only. The field training teaches you to be a medic. My Field training officer told me when I started..."There's nothing more dangerous than an EMT with only class experience"

 

[JPINFV]

So basically you lose any and all ability to interview bystanders if a patient is altered or get report from healthcare providers if in a long term care facility. Don't get me wrong, I'm a firm believer that a "sick/not sick" style assessment can be done in about the time it takes to go from the door to the patient. As such, I see no problem with the immediate load and go treatment EMT-Basics in terms of critical patients. If the patient isn't critical, why shouldn't a proper assessment and treatment be done on scene? Why the rush?

As well, anyone who thinks that class time is only for "exams and practicals" is an idiot. That's like saying a physician only goes to school to pass the USMLE.

 

[Ridryder911]

Sure..

For example, Cardiac patient.

In school you learn all the basic assessment crud, SAMPLE, rapid pat-down to determine DCAPBTLS, OPQRST, load into bus, go to hospital.

In real life.....Get on scene, find patient, load into ambulance, start headed to hospital, then SAMPLE, monitor for SpO2, NIPB, IV start.

In other words, what you learn in school is not really what you do in the field. The class is meant to teach you to pass the exam and practicals only. The field training teaches you to be a medic. My Field training officer told me when I started..."There's nothing more dangerous than an EMT with only class experience"

WHOA!..

I don't know about your so called field officers or how you perform medicine, but if the exposure of that is not the way you do things mentality or that is only to pass the exam, their dangerously playing Russian roulette.


Sorry to inform you, but there is a thing called medical standards. These standards are what you are judged, evaluated and compared to if and when a litigation case comes up. Also, you are informing us that a person with the general maximum level of education of a few nighttime courses is more experienced and knowledgeable than the physician, Paramedic, Critical Care Nurse that authored the book? Anything else you would like to sell with that horse feces?

Yes, not everything is textbook. We all know that, it is not black or white, there is a lot of gray. Yet, at the same time asinine statements such as "load and go" and "do everything en-route" mentality is usually for two reasons. Those that either do not know how or their system sucks so bad, that they have to "hurry" on every call and do not have enough responding trucks, everything has to be done enroute.

The call us a system for a reason. Did you hear the load & go mentality left in the 60's? Hence the reason for EMT's. If you wanted to load and go, why have EMT's? Anyone can do that. Did you not learn or hear about "stabilizing the patient for transport"? Not, stabilize en route or while transporting. Hence the reason EMS was even developed!

Just ask yourself, would your so called heroes win in court? (remember, they will be judged to the curriculum, and to what other EMT's do) Do they really offer care to the patient or just a ride in with some performance en route?

There are very few times, there is a need to rush a patient to the hospital, or perform an assessment or even most of the treatment en route. Those cases again are rare and should be weighted what is best for the patient. Are they really time sensitive? Yes, there is time sensitive cases but again, knowing and when to do such is the part of the job.

Please realize that not all so called EMS services promote or even deliver good care (yes, some call themselves EMS but really are nothing more than a glorified ambulance service) and just because one maybe employed at such may not mean all are that way. I have worked at one (noticed past tense) and refused to continue to do so. There are too many out there that does an excellent job.


Before offering advice, be sure the advice is sound and legitimate.
R/r 911

 

[Flight-LP]

Sure..

For example, Cardiac patient.

In school you learn all the basic assessment crud, SAMPLE, rapid pat-down to determine DCAPBTLS, OPQRST, load into bus, go to hospital.

In real life.....Get on scene, find patient, load into ambulance, start headed to hospital, then SAMPLE, monitor for SpO2, NIPB, IV start.

In other words, what you learn in school is not really what you do in the field. The class is meant to teach you to pass the exam and practicals only. The field training teaches you to be a medic. My Field training officer told me when I started..."There's nothing more dangerous than an EMT with only class experience"

Yes there is, the person who actually believes that garbage you just spewed..................

That assessment "crud" is your backbone of diagnostics. Without it you cannot remotely function to any level of medical provider. Even laypersons learn a basic assessment for the ABC's.

Your real life take is innacurate. What about interviewing pt. on scene, ADMINISTERING OXYGEN PERHAPS, maybe doing a thorough and complete set of manual vitals? Maybe after that you could venture into possible assisting patients with their prescribed medication or if your local protocol allows, give ASA or NTG if not contraindicated. Don't worry about playing with a monitor or pulse oximeter, and you shouldn't remotely be worrying about an IV.

Field training is not where you learn to be a medic, it's where you learn bad habits and hazardous attitudes such as what you have now.

Sorry my friend, but your attitude and beliefs absolutely suck!

 

[ffemt8978]

Training is learning the rules, experience is learning the exceptions...

Knowledge is learning that most things are exceptions rather than rules.

Wisdom is learning how to differentiate between them.

 

[Hastings]

That assessment "crud" is your backbone of diagnostics. Without it you cannot remotely function to any level of medical provider. Even laypersons learn a basic assessment for the ABC's.

I'm sure I cover it in my assessments unknowingly, but I have no idea what CRUD is. What is CRUD?

 

[JPINFV]

My EMT-Basic instructor was able to work "CHOD" into a memory aid (Shock: cardiogenic, hypovolemic, obstructive, distributive).

 

[marineman]

the Op has already finished school so if he isnt prepared then shame on his Instruc

Oh wow. Your instructor isn't there to forcibly make you pass the NREMT. Your instructor is simply there to guide the learning that you should be doing on your own. If you fail a test it's because you didn't put the effort in on your end to actually understand the information.

R/r you sure get picked on a lot because you don't tell people exactly what they want to hear. Let me say I would love to have you as my instructor as I'm sure I would come out an amazing paramedic because you make people actually give more than an ounce of effort. You get the prize for the best advice in the thread with your first post.

To the OP something you will realize is people are not trying to bash you or put you down but coming here and posting rather than looking in the text is the easy way out and if we just told you the answers you would memorize them for the test and not be able to apply them 6 months down the road when faced with a real situation.

Threads like this seem to be fairly common around here and here's my view on how to get better results in the future. Write down the questions you want to ask, look through your text to see what it says the answer should be, then come on here and post the question and the answer and say why is it done this way. That method shows that you don't want the easy answer but you want to be able to understand something.

An example from your question: On a witnessed arrest you immediately place the pads, then begin CPR (all of this after ABC's blah blah). On an unwitnessed arrest you do 2 cycles of CPR then apply the pads. Why is this the case?

I'm going to guess that had you asked it in that manner the answers would've said something about the BP dropping during the time that they were down from blood weeping out of veins and through capillaries and doing compressions will help bring pressure back up and you will have better results from a defib if they have a higher pressure at the time that their heart starts.

 

[Hastings]

An example from your question: On a witnessed arrest you immediately place the pads, then begin CPR (all of this after ABC's blah blah). On an unwitnessed arrest you do 2 cycles of CPR then apply the pads. Why is this the case?

To prime the pump!

Haha, I'm so sick of hearing that phrase. I still have no idea what it means.



Also, you're wrong. On a witnessed arrest, you immediately attach the pads, assess rhythm, and shock (rhythm permitting, though odds are that anyone who arrests in front of you is in such a rhythm), THEN get to CPR. Or you can punch them in the chest first. That's also acceptable.

 

[JPINFV]

To prime the pump!

Haha, I'm so sick of hearing that phrase. I still have no idea what it means.

It comes from people comparing the heart to a mechanical pump a little too much. In a mechanical pump, you want to have liquid in the pump before you start it so that the pump isn't running dry. A pump that has has liquid in it is "primed" and the act of putting water in it is "priming." Of course the similarities between mechanical pumps and biological pumps essentially ends after the idea that both move fluid, hence why the analogy is a little off.